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https://www.readbyqxmd.com/read/28874067/sural-flap-use-for-the-treatment-of-wounds-with-underlying-osteomyelitis-graft-size-a-predictor-in-outcome-a-systematic-review
#1
Sham Persaud, Anthony Chesser, Ryan Pereira, Adrianne Ross
The sural flap procedure is a versatile technique that can be used to cover many types of defects about the lower extremity. The management of soft tissue defects of the lower extremity with underlying osteomyelitis is difficult. The goal for any of these patients is to create a biomechanically stable foot for weight-bearing purposes with no continued infection. Data were gathered using multiple databases from the years 2000 to 2016. Data were compiled looking at the number of subjects, age, comorbidities, number of complications, number of failures, and average flap size of complications/failures...
September 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28872686/weak-bones-in-diabetes-mellitus-an-update-on-pharmaceutical-treatment-options
#2
REVIEW
Daphne P L Lin, Crispin R Dass
OBJECTIVES: Diabetes mellitus is often associated with a number of complications such as nephropathy, neuropathy, retinopathy and foot ulcers. However, weak bone is a diabetic complication that is often overlooked. Although the exact mechanism for weak bones within diabetes mellitus is unclear, studies have shown that the mechanism does differ in both type I (T1DM) and type II diabetes (T2DM). This review, however, investigates the application of mesenchymal stem cells, recombinant human bone morphogenetic protein-2, teriparatide, insulin administration and the effectiveness of a peroxisome proliferator-activated receptor-ϒ modulator, netoglitazone in the context of diabetic weak bones...
September 5, 2017: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/28870053/-domestic-external-fixator-application-in-the-treatment-of-limb-deformities-7-289-cases-application-report
#3
S H Qin, B F Guo, X J Zheng, S F Jiao, H T Xia, A M Peng, Q Pan, J C Zang, Z J Wang
Objective: To discuss the clinical application and effects of domestic external fixator in the treatment of patients with malformations of limbs. Methods: A total of 7 289 patients with malformation of limbs who had been operated in Qin Sihe orthopedic surgery team from January 1989 to June 2016 were retrospective analyzed. The patients were treated with domestic external fixator, including 4 033 males and 3 256 females, aging from 2 to 82 years with a mean age of 23.4 years. There were 2 732 patients using Ilizarov external fixator, 4 713 patients using hybrid external fixator, 57 patients using monobrachial external fixator, 232 patients using Ilizarov external fixator and hybrid external fixator...
September 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28865590/matrix-associated-stem-cell-transplantation-mast-in-chondral-defects-of-the-1st-metatarsophalangeal-joint-is-safe-and-effective-2-year-follow-up-in-20-patients
#4
Martinus Richter, Stefan Zech, Stefan Andreas Meissner
The aim of the study was to assess the 2-year-follow-up of matrix-associated stem cell transplantation (MAST) in chondral defects of the 1st metatarsophalangeal joint (MTPJ). In a prospective consecutive non-controlled clinical follow-up study, 20 patients with 25 chondral defect at the 1st MTPJ that were treated with MAST from October 1st, 2011 to March, 30th, 2013 were analysed. The size and location of the chondral defects range of motion (ROM), and the Visual-Analogue-Scale Foot and Ankle (VAS FA) before treatment and at follow-up were registered...
September 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28865575/single-step-arthroscopic-repair-with-cell-free-polymer-based-scaffold-in-osteochondral-lesions-of-the-talus-clinical-and-radiological-results
#5
Ulunay Kanatlı, Ali Eren, Toygun Kağan Eren, Abdurrahman Vural, Dilan Ece Geylan, Ali Yusuf Öner
PURPOSE: To report the clinical and radiological results of patients with talar osteochondral lesions who were treated by microfracture and cell-free scaffold implantation in a single-step arthroscopic surgery. METHODS: Forty patients, treated with a single-step arthroscopic surgery, were evaluated in this single-center-based retrospective study. Patients with degenerative arthritis (n = 1), history of ankle fracture (n = 1), kissing lesions (n = 1), lower extremity deformity (n = 1), and lesions <1...
September 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28843011/the-bipedicled-medial-plantar-flap-vascular-enhancement-of-a-reverse-flow-y-v-medial-plantar-flap-by-the-inclusion-of-a-metatarsal-artery-perforator-for-the-reconstruction-of-a-forefoot-defect-a-case-report
#6
Mario F Scaglioni, Alberto Franchi, Semra Uyulmaz, Pietro Giovanoli
The pedicled medial plantar (MP) flap is an optimal solution for defects involving the weight-bearing areas of the foot. However, venous congestion is a frequently encountered complication, especially with the reverse-flow variants of the flap, and several strategies have been reported in literature both to prevent and to manage it. In this article, we present the use of a medial plantar flap based distally on the lateral plantar artery with the adjunct of an extra metatarsal perforator from the dorsalis pedis artery as a vascular enhancement to avoid the venous congestion and to improve the overall circulation...
August 26, 2017: Microsurgery
https://www.readbyqxmd.com/read/28842095/functional-outcomes-after-heel-pad-reconstruction-a-review-of%C3%A2-7%C3%A2-cases
#7
Koh Khai Luen, Wan Azman Wan Sulaiman
Sensate, durable heel pad reconstruction is challenging. The present study assessed the functional outcomes after heel pad reconstruction using various flap techniques at our institution. From June 2011 to June 2016 (5-year period), 7 consecutive patients underwent heel pad reconstruction for various etiologies, with 3 microvascular free flaps (42.9%; 2 musculocutaneous flaps [66.7%] and 1 contralateral medial plantar flap [33.3%]) and 4 local pedicle flaps (57.1%; 3 instep medial plantar artery flaps [75.0%] and 1 distally based reverse sural flap [25...
September 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28820834/super-thin-scip-flap-for-reconstruction-of-subungual-melanoma-aesthetic-functional-surgery
#8
Kyeong-Tae Lee, Bo Young Park, Eun-Ji Kim, Jung-Han Kim, Kee-Taek Jang, Sang-Hee Choi, Dong-Youn Lee, Goo-Hyun Mun
BACKGROUND: This study aimed to use a super-thin, free superficial circumflex iliac artery perforator (SCIP) flap in the functional surgery for treating subungual melanoma and to evaluate its outcomes. METHODS: Forty-one patients with primary subungual melanoma of ≤ 2-mm thickness who were treated with functional surgery were prospectively enrolled. Following oncologic resection, a thin SCIP flap was harvested along the trans-superficial fat layer and transferred to the defect with further thinning by primary defatting...
August 8, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28817240/prenatal-presentation-of-mabry-syndrome-with-congenital-diaphragmatic-hernia-and-phenotypic-overlap-with-fryns-syndrome
#9
Kara K Reynolds, Jane Juusola, Gregory M Rice, Philip F Giampietro
We report on a family in which initial features were compatible with Fryns syndrome. The first sibling was a stillborn female with a left diaphragmatic hernia (DH). Her clinical features overlapped with Fryns syndrome. The second pregnancy, a male fetus, was followed for polyhydramnios, hypoplastic mandible, mild enlargement of the fetal bladder, hydronephrosis, and rocker bottom foot deformities. He had facial features similar to his sibling and a large cleft of the secondary palate, small jaw, and secundum atrial septal defect...
August 17, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28790476/surgical-treatment-of-sanders-type-2-calcaneal-fractures-using-a-sinus-tarsi-approach
#10
Chul Hyun Park, Dong Yeol Lee
BACKGROUND: Calcaneum is the most commonly fractured tarsal bone. The optimal treatment for displaced calcaneus fractures involving the posterior facet is surgical. The extensile lateral approach is commonly preferred because it provides sufficient exposure of the subtalar facet. However, this technique has the risk of complications such as wound necrosis and sural nerve injury. Various minimally invasive approaches, such as sinus tarsi approach, limited posterior approach, and percutaneous approach, have been introduced to reduce possible complications...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28775002/kindlin-2-association-with-rho-gdp-dissociation-inhibitor-%C3%AE-suppresses-rac1-activation-and-podocyte-injury
#11
Ying Sun, Chen Guo, Ping Ma, Yumei Lai, Fan Yang, Jun Cai, Zhehao Cheng, Kuo Zhang, Zhongzhen Liu, Yeteng Tian, Yue Sheng, Ruijun Tian, Yi Deng, Guozhi Xiao, Chuanyue Wu
Alteration of podocyte behavior is critically involved in the development and progression of many forms of human glomerular diseases. The molecular mechanisms that control podocyte behavior, however, are not well understood. Here, we investigated the role of Kindlin-2, a component of cell-matrix adhesions, in podocyte behavior in vivo Ablation of Kindlin-2 in podocytes resulted in alteration of actin cytoskeletal organization, reduction of the levels of slit diaphragm proteins, effacement of podocyte foot processes, and ultimately massive proteinuria and death due to kidney failure...
August 3, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28768288/reliability-and-validity-of-a-smartphone-paired-pulse-oximeter-for-screening-of-critical-congenital-heart-defects-in-newborns
#12
Maurice J Huizing, Eduardo Villamor-Martínez, Ingrid A Chavagne, Ward Y Vanagt, Marc A E Spaanderman, Eduardo Villamor
BACKGROUND: Barriers to widespread implementation of pulse oximetry screening of critical congenital heart defects (CCHD) in newborns include increasing trends of out-of-hospital births and cost of equipment. In recent years, smartphone-compatible pulse oximeters have appeared on the market, but the validity of such devices in the setting of CCHD screening has not been evaluated. OBJECTIVES: To compare the performance in CCHD screening of a smartphone-paired pulse oximeter (Masimo iSpO2-Rx™) and a hospital-grade pulse oximeter (Masimo Radical-7™)...
August 3, 2017: Neonatology
https://www.readbyqxmd.com/read/28767168/the-possibility-of-free-tissue-transfer-as-a-nutrient-flap-for-critical-ischemic-foot-a-case-report
#13
Kentaro Tanaka, Kimihiro Igari, Mitsuhiro Kishino, Satoshi Usami, Tsutomu Homma, Takahiro Toyofuku, Yoshinori Inoue, Mutsumi Okazaki
Microsurgical procedure of free tissue transfer in critical limb ischemia patients with large ulceration has already been established. The nutrient flap concept was that transferred tissue functioned not only to cover the skin defect but also as a supplementary blood supply to the ischemic lower leg. This report showed the justification for this concept, which was rarely discussed. A 58-year-old male patient with progressive forefoot gangrene caused by arteriosclerosis obliterans was presented. The distal bypass procedure was performed as revascularization surgery, and a latissimus dorsi (LD) myocutaneous flap was transplanted to cover ulceration...
August 2, 2017: Microsurgery
https://www.readbyqxmd.com/read/28754555/elastin-insufficiency-causes-hypertension-structural%C3%A2-defects-and-abnormal-remodeling-of%C3%A2-renal-vascular-signaling
#14
Elizabeth A Owens, Li Jie, Beverly A S Reyes, Elisabeth J Van Bockstaele, Patrick Osei-Owusu
Elastin deficiency causes vascular stiffening, a leading risk for hypertension and chronic kidney disease (CKD). The mechanisms mediating hypertension and/or CKD pathogenesis due to elastin deficiency are poorly understood. Using the elastin heterozygous (Eln+/-) mouse model, we tested whether renal dysfunction due to elastin deficiency occurs independently of and precedes the development of hypertension. We assessed blood pressure and renal hemodynamics in 30-day and 12-week-old male and female mice. At P30, blood pressure of Eln+/- mice was similar to wild-type controls; however, renal blood flow was lower, whereas renal vascular resistance was augmented at baseline in Eln+/- mice...
July 26, 2017: Kidney International
https://www.readbyqxmd.com/read/28752185/the-subchondral-bone-healing-after-fixation-of-an-osteochondral-talar-defect-is-superior-in-comparison-with-microfracture
#15
Mikel L Reilingh, Kaj T A Lambers, Jari Dahmen, Kim T M Opdam, Gino M M J Kerkhoffs
PURPOSE: Arthroscopic bone marrow stimulation (BMS) has been considered the primary surgical treatment for osteochondral defects (OCDs) of the talus. However, fixation has been considered as a good alternative. Recently, a new arthroscopic fixation technique was described: the lift, drill, fill and fix procedure (LDFF). The purpose of this study was to evaluate the clinical and radiological results between arthroscopic LDFF and arthroscopic BMS in primary fixable talar OCDs at 1-year follow-up...
July 27, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28736619/the-role-of-orthobiologics-in-foot-and-ankle-surgery-allogenic-bone-grafts-and-bone-graft-substitutes
#16
REVIEW
James Wee, Gowreeson Thevendran
Orthobiologics are biological substances that are used therapeutically for their positive effects on healing skeletal and soft-tissue injuries. The array of orthobiological products currently available to the foot and ankle surgeon is wide, and includes bone allografts, bone substitutes, growth factors, and chondral scaffolds. Nonetheless, despite the surge in interest and usage of orthobiologics, there remains a relative paucity of research addressing their specific applications in foot and ankle surgery. In this review, we attempt to provide an overview of the literature on commonly available allogenic bone grafts and bone substitutes...
June 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28731670/calcaneus-osteomyelitis-secondary-to-guthrie-test-case-report
#17
Tugce Tural Kara, Tugba Erat, Halil Ozdemir, Aysun Yahsi, Suat Fitoz, Ergin Ciftci, Erdal Incea
Calcaneus osteomyelitis is a rare infection in newborns. Invasive procedures, prematurity and low birth wight are some causative factors. The clinical signs may be mild. We report a neonate with calcaneous osteomyelitis which was secondary to a Guthrie test sample. She was admitted to hospital with swelling, redness and increased temperature on her heel. Superficial tissue ultrasound showed fluid collection with heavy content was observed on the posterior of the right foot. Puncture and drainage was performed and methicillin-susceptible Staphylococcus aureus was isolated from the drainage culture...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28716695/the-nugget-design-a-modified-segmental-gracilis-free-flap-for-small-sized-defect-reconstruction-on-the-lower-extremity
#18
M Tremp, C M Oranges, W J Wang, R Wettstein, Y X Zhang, D J Schaefer, D F Kalbermatten
BACKGROUND: Little attention has been given to the segmental free gracilis muscle flap supplied by secondary proximal pedicles. We introduce a technical refinement for small-sized three-dimensional defect reconstruction on the foot. METHODS: Between November 2013 and August 2016, three patients with a mean age of 66 years (range 47-70 years) were included. A segmental gracilis free flap supplied by the most proximal secondary pedicle was harvested according to a modified "nugget design" to treat small-sized defects on the lower extremity requiring dead space reconstruction...
September 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28713713/reverse-peroneal-artery-flap-for-large-heel-and-sole-defects-a-reliable-coverage
#19
Yogesh C Bhatt, Sumer Singh, Piyush Doshi, Sanjay G Vaghani
BACKGROUND: Large soft tissue defects of ankle and foot always have been challenging to reconstruct. Reverse sural flaps, free flaps have been used for this problem with variable success. Reverse peroneal artery flap is an option to use with reliability without microvascular repair. Connections of peroneal artery around talus and ankle joint are deep and reliable with anterior tibial and posterior tibial artery. Arterial inflow and venous drainage improved with including short saphenous vein and reverse sural artery in the flap...
May 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28698831/effectiveness-of-reverse-sural-artery-flap-in-the-management-of-wheel-spoke-injuries-of-the-heel
#20
Hafiz U Farooq, Rizwan Ishtiaq, Shabana Mehr, Sadia Ayub, Umer H Chaudhry, Anam Ashraf
OBJECTIVE: Soft tissue injuries at the level of lower extremities, plantar, and dorsal foot pose a surgical challenge for reconstructive surgeons. This kind of injury commonly occurs when lower limbs get stuck in between the spokes of the wheel. Reverse sural artery flap has been proven to be an effective option to cover such defects. The aim of this study is to analyze the demographic variables of affected individuals, technical aspects of reverse sural artery flap, quantify the effectiveness of reverse sural artery flap among various treatment options available, and to study the outcome of injury...
June 10, 2017: Curēus
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